Tag Archives: waiver

The Virginia General Assembly passed its 2014-2016 budget bill earlier this summer. Unfortunately, the state budget represented a major step back in state policy affecting Virginians with intellectual and developmental disabilities and their families.

Action on the budget bill was delayed due to the heated debate about Medicaid Expansion. Various versions of the budget were presented in negotiations over this 3 month period and ID/DD Waivers were often caught in the crosshairs. Some versions of the budget added 50-500 Waivers, while other versions eliminated all Waivers above the DOJ minimum from the budget. Complicating matters further, a $1.5 billion, unanticipated revenue shortfall was announced in early June. This left legislators with the task of “trimming” $1.5 billion in spending from the final version of the bill.

In the end, only 25 new ID Waivers and 15 new DD Waivers were provided to help the more than 8,500 Virginians with intellectual and developmental disabilities on waiting lists in FY15 (July 1, 2014-June 30,2015). This action, which funds less than 0.5% of the entire waiting list, is devastating to many Virginians with I/DD. Unfortunately, some members of the General Assembly cited the reason for the historically low funding as being due to Virginia’s “overfunding” the I/DD Waiver waiting list. This is because the number of ID/DD Waivers provided in the previous session (2013) exceeded the minimum number of Waiver slots required by the DOJ settlement agreement.

The DOJ agreement represents “the floor” when it comes to helping people with I/DD, not the ceiling. While it is technically true that the consent decree requires a certain number of ID/DD Waivers to be funded and also allows the Commonwealth to “count” any additional Waivers it provides towards the next fiscal year, the settlement agreement ALSO requires that the Commonwealth PREVENT the unnecessary institutionalization of people with I/DD. Without the additional I/DD Waiver funding, or equivalent community-based support, hundreds of people with I/DD may be unnecessarily placed in institutions. This is completely inconsistent with the ADA as interpreted by the Olmstead decision.

At the same time it provided historically low funding for the I/DD Waiver waiting lists, Virginia’s state legislature proposed a workgroup be established to look at expanding the number of Training Centers that will remain open. This is in spite of the fact that Virginia’s second-largest state I/DD institution, Southside Virginia Training Center (SVTC), successfully closed on June 30 of this year without incident. Keeping these Training Centers open would cost the state hundreds of millions of dollars, which would come at the expense of the 8,500 Virginians with I/DD and their families who continue to wait for community-based care. The support needs of these Virginians are no different than those in the Training Centers.

It should be noted that the General Assembly did provide 50 ID Waivers and 15 DD Waivers in Fiscal Year 2016 , in addition to providing the ID/DD Waivers required by the agreement, to help individuals/families on waiting lists. Advocates remain deeply concerned, however, about ramifications of state budget in the current fiscal year. Just in the last month alone, The Arc advocates have already fielded several emergency family member calls that illustrate the urgency of the waiting list crisis. What do some of these emergencies look like?

AB was living his father who is in his nineties. His mother passed away last year. When AB’s father had medical complications, he was placed in a nursing home. This left AB with no support and placed him at immediate risk of institutionalization.

CD’s mother reached out to us because she and her daughter had recently become homeless. The family was living in a motel and was unsure where they would be next week. Without a Waiver, the family would continue to face enormous challenges.

Due to an inability to access ID Waiver services, EF was placed in an out of state residential program. EF, who is still in school, wants to be closer to her family and EF’s mother desperately wants to bring her home. Due to EF’s intensive support needs that require 24/7 assistance, this is virtually impossible without the help of an ID/DD Waiver.

GG and HG are an elderly couple in their eighties. They have provided support to their adult son with ID for more than fifty years and just found out about the ID Waiver this month. After meeting a local chapter representative who told them about the ID Waiver, they quickly signed up for the waiting list. GG and HG both experience significant health issues and are concerned for their son’s future if something is to happen to them.

These stories represent just a few of the hundreds, if not thousands, of crisis situations that can be found on the ID and DD Waiver waiting lists. Vigorous advocacy will be needed to ensure that these families and others get the help they so desperately need. The Arc of Virginia will remain dedicated to strengthening and growing grassroots advocacy moving forward, but we will need your help!

Please stay tuned for important action alerts, budget hearing dates and other ways you can help ensure the voices of Virginians with I/DD are heard. Please take action when you see these requests. Our efforts will culminate in a statewide “Developmental Disability Advocacy Day” at the State Capitol on January 26- the three year anniversary of the US v Virginia settlement agreement announcement.

If you’d like to learn more about the 2014 Budget Bill and how it affects Virginians with I/DD, please click here. This summary is a side-by-side comparison of various versions of the budget bill, including the final version that was signed by Governor McAuliffe on June 23, 2014.

On December 16, Governor McDonnell released his proposed state budget for 2014-2016. The state budget includes adjustment in the current Fiscal Year 2014 (FY14) budget (the so-called “caboose” budget). It also includes the next biennium budget covering Fiscal Year 2015 (July 2014-June 2015) and Fiscal Year 2016 (July 2015-June 2016). The state budget is very important because it determines the number of Virginians with intellectual and developmental disabilities (I/DD) who will gain access to essential long-term services and supports over the next 30 months. It will also determine the types of services and supports that will be available to people with I/DD, as well as the quality of those services and supports.

While the Governor’s proposed budget provides the additional I/DD waiver slots called for in the Commonwealth’s agreement with the U.S. Department of Justice (DOJ), the budget does not provide sufficient funds to address the growing backlog in unmet needs among the I/DD population and achieve the long-range goal of the settlement agreement ie., ensuring that all Virginians with I/DD, regardless of the complexity of their support needs, can receive the services and supports they need in the most integrated settings possible. Under the proposed budget, the waiting list for I/DD services- currently approaching 8,000- will increase by an additional 1,500 people by the end of the next biennium (i.e., by June 30, 2016).

The initial set of recommendations from the waiver redesign study has not been released. While The Arc of Virginia is hopeful that the study will result in a variety of badly needed changes in waiver program and policies, it is important to point out that these changes will not be fully implemented until Fiscal Year 2016 (FY16). In the meantime, people with intellectual and developmental disabilities will continue to face many of the same barriers to community integration as they do at present.

To make matter worse, Virginia has yet to adopt a unified approach to administering I/DD services. Examples of the inadequacies in the current approach include:

The budget does not include a commitment to reinvesting cost savings associated with the phase down and eventual closure of state-operated training center closures in enhancing statewide capacity to serve individuals with I/DD in home and community-based settings.

Accountability for overseeing key components of I/DD services continues to be divided between the Department of Behavioral Health and Developmental Services (DBHDS) and the Department of Medical Assistance Services (DMAS). Competing interagency priorities leads to inconsistent decision making and delays that thwart progress in implementing the DOJ settlement agreement and related I/DD system reforms.

The proposed budget language suggests that the Commonwealth intends to press forward with enrolling long-term services and supports for all Medicaid recipients-including all public and private ICF/IDD residents and all participants in I/DD wavier programs- into Medicaid managed care plan operated by private, profit-making companies beginning in FY 2016.

There has been little budget transparency and minimal stakeholder engagement with the respect to the development of I/DD Waiver programs and policies.

These are big issues and they require immediate attention. In response to the Governor’s proposed budget, The Arc of Virginia is in the process of finalizing its legislative priorities for the upcoming session of the General Assembly. The general aim will be to advance community integration for all Virginians with intellectual and developmental disabilities and facilitate compliance with the terms of the DOJ settlement agreement. This is an important time for Virginia. If we fail to achieve the types of system reforms called for in the agreement, we may not get another chance in the years ahead.

We are urging the Commonwealth to uphold its commitments to eliminating the waiting list for I/DD services and to helping people with I/DD live in the most integrated settings. To accomplish this goal, however, we will need your help. A series of action alerts will follow in coming weeks, letting you know how you can help improve services and supports for people with I/DD and make the vision of “A Life Like Yours” a reality. The first “Call to Action” is to make sure that we speak out and have a strong presence at the regional budget hearings on January 3rd. More information about this important advocacy event will follow later this week.